As the opioid epidemic in America rages on, many treatment facilities struggle to meet the health needs of freshly sober individuals, leaving them no option but to seek medical care outside the facility, increasing their likelihood to relapse.

At Crossroads for Women in Phoenix, that’s no longer a concern. In February 2016, the residential treatment center partnered with the Student Health Outreach for Wellness (SHOW) community initiative, a tri-university, student-run program serving vulnerable populations.

Over those two years, students from Arizona State University, Northern Arizona University and the University of Arizona have served over 700 patients and given about $95,000-worth of free services at Crossroads. As a result, both length of stay and patient satisfaction have increased, and medical-related incident reports have fallen to zero.

The partnership is supported by the National Center for Interprofessional Practice and Education at the University of Minnesota, and was funded through the Robert Wood Johnson Foundation, the John A. Hartford Foundation, the Josiah Macy Jr. Foundation and the Gordon and Betty Moore Foundation.

“I am so pleased that this partnership has been impactful to both SHOW and Crossroads,” said Liz Harrell, assistant clinical professor at ASU’s College of Nursing and Health Innovation and director of SHOW.

ASU assistant clinical professor Liz Harrell laughs as the team takes notes on the day's cases during the morning huddle of the Student Health and Outreach Wellness clinic at Crossroads residential and outpatient substances abuse treatment program in Phoenix. Photo by Deanna Dent/ASU Now

“SHOW students and faculty are engaged in ‘real-world’ interprofessional care delivery and learning about how to care for those recovering from substance-use disorders. Crossroads residents are recipients of integrated care not usually available in residential settings. … We could not have asked for a better collaborative outcome.”

Crossroads program coordinator Jenice Johnson agrees. She described the improvement in quality of care provided to patients as “amazing and drastic.”

Before she was employed at Crossroads, she was a patient there. After only a week at the facility, she developed a case of bronchitis and had to leave to seek treatment at a hospital.

“That was probably one of the scariest experiences I had,” Johnson said.

She’s grateful patients don’t have to worry about being in that kind of situation anymore.

“With SHOW being here and (the patients) being able to talk to somebody who cares and can help them get care, it’s kind of just a mind ease,” she said. “And it also helps with … somebody being two days sober and having to leave by themselves on the bus to go to the emergency room and then not returning. Or returning high.”

SHOW was founded as a service-learning program to provide health care to individuals who lack the means to get it themselves, including those experiencing homelessness, those from low-income communities and those recovering from substance use.

Video of S.H.O.W. at Crossroads

Video by Deanna Dent/ASU Now

The gap in care is the result of a broken system in which health care is tied to employment, Harrell said.

“If you don’t have an employer that offers health care or you’re out of a job, you’re also out of luck,” she told ASU Now in 2016, and maintains that that’s still the case two years later.

In addition, Harrell said, the systems is “fundamentally disjointed.”

That’s why SHOW uses what’s called an interprofessional practice health care delivery method, meaning students from multiple disciplines — including nursing, psychology and social work — work together to provide more holistic care to patients.

Nikole Sciortino, a social work senior, chose to work with SHOW to fulfill her field internship requirement precisely for that reason.

“I get to work with different disciplines, and that’s really important being in my field because we do a lot of referrals, and we have to know certain signs (someone might exhibit) before we refer a client to another person,” she said.

For example, an individual in recovery might be inclined to lie about their substance use, but a social worker might not be able to suss them out without insight from a colleague trained in psychology.

The cross-benefits don’t just happen between students, though. Johnson has noticed how interactions between students and Crossroads employees have resulted in better patient care as well.

“Before this, I didn’t have any medical knowledge,” she said. “And I know for a lot of the students, they don’t have any knowledge of substance abuse. So us being able to learn from each other … (has produced vast improvements).”

Crossroads women's program coordinator Jenice Johnson gives advice on how to approach a patient during the morning huddle. Photo by Deanna Dent/ASU Now

Crossroads currently operates six facilities in the Valley. By January 2019, the goal is for SHOW to have a presence at all of them. Right now, SHOW supplies the facility with a family nurse practitioner, a psychiatric nurse practitioner, social workers and physical therapists, and plans to add legal experts soon.

SHOW is also in the process of building a shared clinic with Crossroads that will employ community providers as well as faculty to continue the service-learning model for students.

“Ultimately, we’re a learning lab where students learn how to work with other disciplines to provide care for a patient,” Harrell said.

Other student-run free clinic programs across the country have taken notice, adapting signature concepts from SHOW, such as a “patient navigator,” someone who stays with the patient throughout their entire clinic visit, acting as their health advocate and ensuring important information is accurate and passed along to the right care providers.

Several SHOW students have developed and implemented new strategies or initiatives as academic research projects while working at Crossroads. Every single one has been adopted at the facility, including a mindfulness education group.

The experience is invaluable, and not something you get from most internships, Sciortino said.

“It gives people like me, an undergrad, the opportunity to really take the lead on something. I’ve had different leadership positions before but this time I really feel like I’m in charge of stuff,” she said.

“I feel like I’m getting the best type of experience I can because it’s all hands-on learning. … I’m actually getting to experience the situation myself and having to do the problem solving on my own, which is a key part of the field internship so that I know what I’m doing when I graduate.”

Top photo: ASU doctoral student in advanced nursing practice Reena Pathak asks her patient questions during their morning meeting at the Student Health and Outreach Wellness clinic at Crossroads residential and outpatient substances abuse treatment program in Phoenix. Photo by Deanna Dent/ASU Now

Emma Greguska

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Editor's note: To demystify the process of attaining distinguished graduate fellowships, ASU Now will feature a multipart series of interviews with distinguished graduate award recipients from across the ASU community. The series will showcase the achievements of ASU’s distinguished graduate award recipients and highlight the strategies that led to those achievements. Sept. 17-21 is National ...

One postdoc’s relentless pursuit of a Ford Foundation Fellowship

Alexandrina Agloro shares her contribution to ASU’s ‘culture of pursuit’

September 18, 2018

Editor's note: To demystify the process of attaining distinguished graduate fellowships, ASU Now will feature a multipart series of interviews with distinguished graduate award recipients from across the ASU community. The series will showcase the achievements of ASU’s distinguished graduate award recipients and highlight the strategies that led to those achievements.

In keeping with that spirit, ASU Now talked to Alexandrina Agloro for this installment of our "culture of pursuit" series.

Agloro will join ASU as a postdoctoral fellow in January and will be an assistant professor at the School for the Future of Innovation in Society starting in fall 2019. She’s also a Ford Foundation Fellowship recipient.

Through its fellowship programs, the Ford Foundation seeks to increase the diversity of the nation’s college and university faculties by increasing their ethnic and racial diversity, to maximize the educational benefits of diversity, and to increase the number of professors who can and will use diversity as a resource for enriching the education of all students.

One way that the Foundation carries out its mission is by awarding predoctoral, dissertation and postdoctoral fellowships to outstanding applicants who embody and share its mission. Fellows receive an annual stipend of between $24,000 and $45,000 for one to three years, depending on the type of fellowship.

So, what does it take to win a Ford Fellowship? Agloro, ASU’s 2018 postdoctoral Ford fellow, indicates that sheer determination is at least one vital element. She shared some of the details of her Ford Fellowship pursuit, her choice of ASU as her place of research, and her future role as tenure-track faculty at ASU.

Question: How did you find out about Ford Foundation Fellowships?

Answer: So, I have been applying for the Ford Fellowship for years! I applied as a predoctoral candidate and was an honorable mention. I applied for the dissertation fellowship and was an alternate. And, I applied for the postdoc fellowship last year and was an alternate; I am relentless. I applied again, and I finally got one!

I was really lucky in graduate school to be part of an NSF-funded EDGE program, “Enhancing Diversity in Graduate Education,” at the University of Southern California where I did my PhD. I had fantastic mentorship, and I was looped into Ford as a place where you’ll get really good support for faculty of color, for grad students of color — in closing the gap between what universities offer and the specialized needs for students at generally predominantly white institutions.

Q: What made you choose ASU?

A: I have been super excited about the ways ASU has been innovating higher education. ASU has been on the forefront of acknowledging that the educational system as it exists right now … the model doesn’t work anymore. ASU has been willing to take the risk to find another model that can work. It's doing this in a landscape where universities are hiring more and more administrators and fewer tenure-track faculty, and student fees are skyrocketing. And, it seems that ASU is trying to keep costs down, trying to hire more faculty, and trying to find ways to engage populations that don’t have access to traditional higher education. That’s what I loved about ASU. It’s a Hispanic-serving institution, and it has a concerted effort to bring in enough Native students to match the population of the state.

Q: As a Ford Fellowship winner, an ASU postdoc and a soon-to-be faculty member at the School for the Future of Innovation in Society (SFIS), how are you going to juggle all of that?

A: SFIS has been so generous and accommodating in helping me figure out how to make the transitions. When I interviewed for the position, I told them that I had applied for the fellowship, and if I got it, it would be at ASU and I’d really like to be able to do it. And they said, OK, we will sort this out and, if you get it, we will embrace it. We will find a way to do this. Just let us know. So, I started negotiations, and I was able to call the director and say, "By the way, I got this postdoc." He said, "Well, can your fellowship money buy out your teaching? If so, then we’ll do that." So, it's really lucky that I get to come to ASU, get acclimated, and just do research before I jump in and start teaching.

Q: This may be a loaded question, but what’s your dream job — where do you want to be five years from now?

A: I’m really lucky that I’ve already had one tenure-track job. It's so much easier to look for a job when you have a job because you know what you're looking for and what you want. I came out for my campus visit to ASU highly suspicious of the whole thing. I mean, hello, it would have to be pretty stellar and phenomenal to uproot my whole life and move across the country. I’m three years into my tenure-track job here (at Worcester Polytechnic Institute). Things are fine. But SFIS just wowed me.

What I love is that the position they are bringing me in for is "Science Technology and Innovation in the Borderlands." It is bringing together the two things that I’ve been trained in, which seem separate, but I’m trained in both cultural and ethnic studies and interactive media and game development. I am an ethnic studies interactive media artist. And, that is exactly what SFIS wants me to do.

In my previous job, I was teaching design courses and was not fully able to engage my interest in ethnic and cultural studies and my interest in why we play games to make the world a better place. The intrinsic motivation for playing games can be utilized for other things, and that’s what I’m interested in exploring in my research, my writing and my teaching. What was so great and different about the SFIS job was that they weren’t looking for someone to fill XYZ position. They really seemed interested in hearing me out and liking my ideas and saying, great, we want to support you to build some (cool) stuff, so this is what we can do if you come here. They asked, "What would you be interested in teaching if you come here?" And, that was a really fun conversation. So, where do I want to be five years from now? I just really think I want to be at ASU.

Q: In your free time, when you have any, what do you like to do?

A: I always find a way to weave my work into whatever I do. But, I’m really looking forward to exploring the Southwest and being outside in the time of year that most people (in Massachusetts) can’t be outside. I have an 11-year-old French bulldog, and we like to hang out in public together. We'll go exploring.